title: Serum antibody responses to bacterial enteropathogens in Swedish travelers to south-east Asia.
abstract: The possibility that serological analysis may be more sensitive than bacteriological examinations of stool samples to detect enteric infections was evaluated in 80 Swedish travellers to South-East Asia. Serum and faecal specimens were collected before, during and after their travel. Serological analyses of pre-travel and any later serum specimen identified infection with enterotoxinogenic Escherichia coli (ETEC), Salmonella or Campylobacter jejuni in 28% of the travellers. The seroconversion rate was 72% in travellers excreting the homologous pathogen in their stool; all symptomatic cases and half of those who had an asymptomatic infection seroconverted. Bacteriological examinations of stool samples collected repeatedly during travel identified an enteropathogen in 20% of the travellers. However, the isolation rate decreased to 11%, when only a single routine faecal specimen was examined. Our findings suggest that serological analyses of pre- and post-travel specimens are sufficiently specific and may be at least as sensitive as conventional bacteriology to identify infections with bacterial enteropathogens in travellers. However, reliable serodiagnosis requires collection of pre-travel sera and might therefore only be useful in prospective studies of travellers' diarrhoea.
authors.affiliation: Department of Medical Microbiology, University of Göteborg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Jertborn
authors.forename: C
authors.initials: C
authors.lastname: Ahrén
authors.forename: D M
authors.initials: DM
authors.lastname: Perlman
authors.forename: B
authors.initials: B
authors.lastname: Kaijser
authors.forename: A M
authors.initials: AM
authors.lastname: Svennerholm
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology*; D001210:Asia, Southeastern; D001427:Bacterial Toxins / Q000276:immunology; D002169:Campylobacter Infections / Q000097:blood / Q000276:immunology; D016123:Campylobacter jejuni / Q000276:immunology*; D003967:Diarrhea / Q000382:microbiology*; D004768:Enterotoxins / Q000276:immunology; D004926:Escherichia coli / Q000276:immunology*; D004927:Escherichia coli Infections / Q000097:blood / Q000276:immunology; D029968:Escherichia coli Proteins; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013548:Sweden / Q000208:ethnology; D014195:Travel
chemical_list: D000907:Antibodies, Bacterial; D001427:Bacterial Toxins; D004768:Enterotoxins; D029968:Escherichia coli Proteins; C034151:heat stable toxin (E coli); C027538:heat-labile enterotoxin, E coli